Diseases

Loge-de-Guyon syndrome

Loge-de-Guyon syndrome


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Similar to the carpal tunnel syndrome, the Loge-de-Guyon syndrome is also based on the pinching off of a nerve on the wrist. Possible consequences are sensations, muscle weakness and paralysis - especially in the ring finger and the little finger.

Definition

Loge-de-Guyon syndrome describes nerve compression of the nerve on the small finger side, the ulnar nerve. It runs through the wrist between two carpal bones - the pea and the hook leg (Os pisiforme and Os hamatum). This constriction is known as the “Loge de Guyon” after its discoverer. There the nerve can be easily pinched off, which triggers disturbances of the sensation and sometimes even symptoms of paralysis. In this case, the clinical picture is defined as “Loge-de-Guyon syndrome”. The symptoms were first described by the French urologist and surgeon Jean Casimir Felix Guyon (1831-1920).

Symptoms and causes

Affected people usually complain of a slight tingling sensation or numbness in the little finger and possibly the ring finger. There is often a connection with acute stress on the wrist, such as when cycling or motorcycling for a long time, but there may also be other triggers such as a leg, a ganglion cyst, a thrombosis or a tumor behind the symptoms. If the compression of the nerve lasts for a long time, the muscles can often shrivel and the tissue relief on the little finger side can be narrowed. In more pronounced forms, the impairments range to paralysis in the fingers and hand.

Diagnosis

If there is a suspicion of Loge-de-Guyon syndrome in view of the symptoms, the nerve conduction speed is first measured on the ulnar nerve or on its branches (superficial ramus, profundus ramus). If delays can be identified in the context of an electron neurography, this is considered evidence of damage to the nerve. With the help of a so-called MR neurography (special magnetic resonance imaging), such as that offered at Heidelberg University Hospital, the cause of the complaints can be further narrowed. According to the university clinic, MR neurography can be used to “precisely map fine nerve branches on the hand” so that “the different forms of Loge-de-Guyon syndrome and the exact damage sites of different nerve branches” can be determined.

When making the diagnosis, it should be noted that another narrowing of the ulnar nerve is located on the elbow, where the nerve runs in a groove and can also be easily pushed off. There are also three constrictions on the neck, under the collarbone and the small pectoral muscle. If no compression of the nerve can be found in the Loge-de-Guyon, the cause of the complaints may therefore be found here. It makes sense to take these bottlenecks into account in any case and to determine whether there are problems here that may contribute to the maintenance of Loge-de-Guyon syndrome and may therefore be therapeutically relevant.

Treatment

The treatment of Loge-de-Guyon syndrome should always be based on the triggers identified. For example, in the case of a ganglioma (over-leg), a ganglion cyst or a tumor, there is no way around a surgical intervention. However, if the cause is an acute overload, immobilization and protection of the wrist can usually lead to a complete resolution of the symptoms. (tf, fp)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

  • Weigel, Bernhard / Nerlich, Michael L .: Practice book trauma surgery, Springer, 2nd edition, 2011
  • German Society for Hand Surgery e. V .: Loge de Guyon syndrome (accessed: August 12, 2019), handexperten.com
  • German Society for Hand Surgery (DGH) / German Society for Neurosurgery eV (DGNC) / German Society for Neurology (DGN) / German Society for Orthopedics and Orthopedic Surgery eV (DGOOC): S3 guideline for diagnosis and therapy of cubital tunnel syndrome, as of November 2017, Guideline detailed view
  • Müller-Vahl, Hermann / Tegenthoff, Martin: Lesions of peripheral nerves and radicular syndromes, Thieme, 10th edition, 2014
  • Bischoff, Christian / Schulte-Mattler, Wilhelm: The EMG book: EMG and peripheral neurology in questions and answers, Thieme, 4th edition, 2015

ICD codes for this disease: G56ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.



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